Preg­nancy risk

Ex­perts are warn­ing that the coun­try’s new fam­ily planning mea­sures could have un­in­tended, but far-reach­ing, con­se­quences. Wang Xiaodong re­ports.

China Daily (Hong Kong) - - FRONT PAGE - Con­tact the writer at wangx­i­aodong@chi­nadaily.com.cn

Since im­ple­men­ta­tion of a uni­ver­sal sec­ond-child pol­icy, more women are giv­ing birth re­gard­less of their health, rais­ing the chance of death.

In re­cent years, the treat­ment of preg­nant pa­tients has be­come an in­creas­ingly thorny task for Liu Wenx­ian, a car­di­ol­o­gist at Anzhen Hospi­tal in Bei­jing, as a re­sult of the rise in the num­ber of older women want­ing to give birth.

“Many of these women are from out­side Bei­jing and have risky com­pli­ca­tions such as car­diac dis­ease,” she said.

“The prob­lem has wors­ened since the adop­tion of the uni­ver­sal two-child pol­icy be­cause these com­pli­ca­tions are more com­monly seen in preg­nant women who have given birth be­fore. In many cases — es­pe­cially when the pa­tient’s con­di­tion is crit­i­cal — we have to re-eval­u­ate their de­ci­sion to have a baby and end the preg­nancy promptly to save their life,” she said.

Gu Hong, a pe­di­a­tri­cian at the hospi­tal who spe­cial­izes in treat­ing car­diac dis­ease in ba­bies, warned that the twochild pol­icy could have un­in­tended, but far-reach­ing, con­se­quences: “We are fac­ing some very harsh chal­lenges. Many women are try­ing their best to have a sec­ond child, even if con­di­tions such as car­diac dis­ease could put them at high risk.”

Ac­cord­ing to Gu, seven preg­nant women have died in the hospi­tal in the past five years as a re­sult of car­diac com­pli­ca­tions, and those risks still ex­ist de­spite im­prove­ments in med­i­cal tech­nol­ogy.

Anzhen Hospi­tal is not alone in fac­ing such a chal­lenge.

Ac­cord­ing to the Na­tional Health and Fam­ily Planning Com­mis­sion, in the first half of the year China’s ma­ter­nity mor­tal­ity rate reached 183 per 1 mil­lion peo­ple, a rise of more than 30 per­cent com­pared with the same pe­riod last year.

Mor­tal­ity rate

Ma­ter­nity mor­tal­ity rates had been de­clin­ing steadily in China un­til the end of last year, when the top lead­er­ship ap­proved the adop­tion of the uni­ver­sal two-child pol­icy to tackle the prob­lems posed by the na­tion’s rapidly ag­ing pop­u­la­tion. As a re­sult, the decades-long fam­ily planning pol­icy, which lim­ited most cou­ples to one child, was re­laxed.

Last year, the mor­tal­ity rate dur­ing preg­nancy fell to 201 per 1 mil­lion peo­ple from 300 per 1 mil­lion in 2010, ac­cord­ing to the com­mis­sion, but the fig­ure is now ris­ing.

“The rise in the num­ber of preg­nant women, par­tic­u­larly those at higher risk such as older women, re­sulted in a rise in ma­ter­nity deaths in some parts of the coun­try in the first half of the year,” said a state­ment re­leased by the com­mis­sion in Oc­to­ber.

The NHFPC es­ti­mates that more than 3 mil­lion women at higher risk will fall preg­nant in China every year be­tween the start of next year and 2020, a rise of 30 per­cent from the pe­riod be­fore the adop­tion of the two-child pol­icy. The com­mis­sion said: “This will cause in­creased risks in ma­ter­nity com­pli­ca­tions and present chal­lenges to treat­ment and re­cov­ery.”

The num­ber of ba­bies born in the first half of the year was 8.31 mil­lion, a rise of 6.9 per­cent over the same pe­riod last year, a sig­nif­i­cant in­crease de­spite the de­clin­ing num­ber of mar­ried women of fer­tile age, the com­mis­sion said.

In ad­di­tion, the sud­den rise in preg­nan­cies has re­sulted in ma­ter­nity ser­vices com­ing un­der greater strain, and both fa­cil­i­ties and hospi­tal staff are un­der-re­sourced, ac­cord­ing to the com­mis­sion.

Of the 90 mil­lion women now el­i­gi­ble to have a sec­ond baby, 60 per­cent are age 35 or older, which means they are con­sid­ered to be at higher risk dur­ing preg­nancy, the NHFPC said.

Gu said about 150 preg­nant pa­tients with car­diac com­pli­ca­tions were re­ceived by Anzhen Hospi­tal last year, com­pared with ap­prox­i­mately 110 in 2011. This year, the num­ber is ex­pected to sur­pass 180.

Act­ing on tra­di­tional be­liefs, many women are opt­ing to have an­other child, ac­cord­ing to Gu: “Many of these pa­tients are seek­ing treat­ment and care in our hospi­tal, but not all women are suit­able for preg­nancy. Women with se­ri­ous con­di­tions are very likely to give birth to an un­healthy child, and their own lives could also be threat­ened dur­ing child­birth.”

Liu, the car­di­ol­o­gist, urged older women to as­sess the risks they face be­fore de­cid­ing to have a child.

“With the rise in age, preg­nant women have a higher chance of de­vel­op­ing ill­nesses. They must be aware of their phys­i­cal con­di­tion be­fore preg­nancy to re­duce the risk to them dur­ing child­birth,” she said.

He Wen­jie, a gy­ne­col­o­gist at the re­pro­duc­tive medicine depart­ment at Xuzhou Ma­ter­nal and Child Health­care Hospi­tal, in Xuzhou, Jiangsu prov­ince, has also seen a rise in the num­ber of older pa­tients: “The av­er­age age of pa­tients I am re­ceiv­ing is ris­ing. It is cru­cial that all women, es­pe­cially those of older age, have check­ups be­fore preg­nancy to re­duce the health risk.”

Pre­ven­ta­tive mea­sures

The NHFPC said health author­i­ties will take more mea­sures in the next few years to im­prove the health of preg­nant women amid ris­ing rates of mor­tal­ity dur­ing preg­nancy.

Hos­pi­tals na­tion­wide will add 89,000 ob­stet­rics beds to in­crease the sup­ply of re­sources and lo­cal author­i­ties will up­grade emer­gency equip­ment at hospi­tal ob­stet­rics and pe­di­atrics de­part­ments.

The com­mis­sion will also se­lect a num­ber of na­tional mid­wifery-training bases and or­ga­nize training re­lated to the treat­ment of preg­nant women with crit­i­cal con­di­tions.

It will also co­op­er­ate with other de­part­ments to pro­vide training, with the aim of pro­duc­ing 140,000 ex­tra ob­ste­tri­cians and mid­wives.

"Many women are try­ing their best to have a sec­ond child, even if con­di­tions such as car­diac dis­ease could put them at high risk.” Gu Hong, a pe­di­a­tri­cian at Anzhen Hospi­tal in Bei­jing, which spe­cial­izes in treat­ing ba­bies with car­diac dis­ease

ZHAO XIAOM­ING / XIN­HUA

Preg­nant women line up for health checks at Ji­nan Ma­ter­nity and Child Care Hospi­tal in Ji­nan, Shan­dong prov­ince, in March. Thirty per­cent of moth­ers-to-be vis­it­ing the hospi­tal are ex­pect­ing their sec­ond child, ac­cord­ing to hospi­tal sources.

ZHOU MI / XIN­HUA

Moth­ers-to-be prac­tice yoga at a training in­sti­tute in Nan­chang, Jiangxi prov­ince, in Jan­uary.

WANG BIAO / FOR CHINA DAILY

A girl kisses her lit­tle brother while their par­ents look on at a hospi­tal in Fuyang, An­hui prov­ince.

Newspapers in English

Newspapers from China

© PressReader. All rights reserved.